Atmospheric predictability of the martian atmosphere: from low-dimensional dynamics to operational forecasting?

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Current approaches to medical care optimization for patients with multimorbidity

Scientific interest to the problem of multimorbidity is increasing due to the increase of the number of such patients. The aim of this work  was to analyze and summarize current approaches to optimizing care for patients with multimorbidity and the results of their implementation in clinical practice. Since the beginning of this century, a number of documents have been created by WHO, government agencies and professional medical societies to improve medical care to patients with multimorbidity. The evidential basis of the effectiveness of the majority of the proposed measures based primarily on expert consensus. In 2016 NICE has published a clinical guideline NG56 «Multimorbidity: clinical assessment and management», WHO – a monograph  «Multimorbidity: Technical Series on Safer Primary Care». In 2017 NICE has published a quality standard – Quality Standard №153 «Multimorbidity». The strategy of improvement of medical care for patients with multimorbidity is directly related to the patient-centered approach formation, which includes comprehensive assessment of the patient's condition. The main component of medical care is the definition of a realistic goal of medical intervention according to patient`s preferences, and making the choice of the optimal amount of diagnostic, treatment, and preventive measures, which can lead to the desired goal. A number of studies (the 3D randomized controlled trial, the MultiCare AGENDA, the SPPiRE study, the WestGem study etc.) have being conducted to evaluate the effectiveness of implementing proposed approaches in clinical practice. The results of the studies and meta-analysis do not provide conclusive evidence of the medical and economic effectiveness of their implementation at the presentstage. Improving the outcomes of medical care to patients with multimorbidity involves conducting further clinical trials that can provide evidence to determine the list of most effective interventions for clinical practice

Multiple solutions to a magnetic nonlinear Choquard equation

We consider the stationary nonlinear magnetic Choquard equation [(-\mathrm{i}\nabla+A(x))^{2}u+V(x)u=(\frac{1}{|x|^{\alpha}}\ast |u|^{p}) |u|^{p-2}u,\quad x\in\mathbb{R}^{N}%] where $A\$is a real valued vector potential, $V$ is a real valued scalar potential$,$ $N\geq3$, $\alpha\in(0,N)$ and $2-(\alpha/N) <p<(2N-\alpha)/(N-2)$. \ We assume that both $A$ and $V$ are compatible with the action of some group $G$ of linear isometries of $\mathbb{R}^{N}$. We establish the existence of multiple complex valued solutions to this equation which satisfy the symmetry condition $$u(gx)=\tau(g)u(x)\text{\ \ \ for all}g\in G,\text{}x\in\mathbb{R}^{N},$$ where $\tau:G\rightarrow\mathbb{S}^{1}$ is a given group homomorphism into the unit complex numbers.Comment: To appear on ZAM

Самооцінка пацієнтами та лікарями виконання вимог здорового способу життя йготовності до змін поведінкових факторів ризику серцево-судинних захворювань

Background. Poor adherence to risk factor behaviors management increases the risk for a further cardiac event. Unfortunately, poor adherence to behaviors recommended in lifestyle interventions is widespread, particularly over the long-term; thus, the “adherence problem” represents a significant challenge to the effectiveness of these interventionsObjective: The goal of the trial was the assessment of patient’s and physician’s attitude to a healthy lifestyle and evaluation of their stage of readiness for change in dealing with unhealthy behavior with the goal of cardiovascular disease risk factors modification particularly smoking cessation, physical activity, healthy dietMethods: We performed a poll of 158 patients who visited the outpatient clinic of the State Institution of Sciences “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department with the purpose of preventive services and of 65 physicians – employees of our clinic – about their adherence to healthy lifestyle habits. As the determination of the readiness to deal with an unhealthy behavior allows making individualized preventive counseling, we used a special questionnaire for standardizing approaches to determining the stage of change of three major behavioral risk factors of cardiovascular diseases – smoking, unhealthy diet, and low level of physical activity. The readiness to change was identified according to the Transtheoretical Model (TTM) of Behavior Change. The results of physicians questionnaire (n=65) were compared to the results of patients questionnaire (n=158). Results. Most of the participants – 87,3±2,6 % of patients and 93,6±3,1 % of physicians – were non-smokers. Only 26,6±3,5 % of patients and 20,6±5,1 % of physicians reported following a healthful diet and only 8,9±2,3% of patients and 20,6±5,1 % of physicians perform regular physical activity. The prevalence of optimal level of physical activity among physicians was significantly higher (p&lt;0,05). 72,5± 6,3 % of physicians were on action stage in the matter of healthy diet and 74±6,2 % – in the matter of physical activity regimen, it was significantly higher (р &lt; 0,05) that among patients – 45,7±4,6 % and 41,0±4,1% respectively. Conclusions: Our findings highlight poor adherence to healthy lifestyle habits among physicians and patients, especially in the matter of healthy eating and optimal level of physical activity, and needs for targeted strategies that improve long-term adherence to health behaviors and enhance physician’s knowledge about lifestyle-based health promotion interventions.Мета – дослідити ставлення пацієнтів і лікарів до виконання вимог здорового способу життя та провести оцінку стадіїготовностідозмін поведінкових факторів ризикусерцево-судинних захворювань.Матеріал і методи. Проведено опитування 158 пацієнтів випадкової вибірки, які проходили профілактичний огляд у Державній науковій установі «Науково-практичний центр профілактичної та клінічної медицини» Державного управління справами(ДНУ «НПЦ ПКМ» ДУС), і 63 лікарів терапевтичного профілю щодо виконання ними вимог здорового способу життя – відсутності тютюнокуріння, дотримання здорового харчування, дотримання оптимального рівня фізичної активності – та готовності до змін нездорової моделі поведінки.Визначення стадії готовності до змін проводили за допомогою стандартизованого опитувальника. Результати внесено до бази даних і проведено статистичну обробку. Результати. Аналіз результатів опитування виявив відмінності в дотриманніокремих компонентів здорового способу життя: не курили серед пацієнтів87,3±2,6% опитаних, серед лікарів – 93,6±3,1%, дотримували здорового харчування 26,6±3,5% пацієнтів і 20,6±5,1% лікарів, дотримували рекомендованого рівня фізичної активності8,9±2,3% пацієнтів і 20,6±5,1% лікарів (p&lt;0,05). Встановлено, що частка лікарів, які перебували на стадії дії щодо дотримання вимог здорового харчування та рекомендованого рівня фізичної активності,була вірогідно вищою порівняно з такою серед пацієнтів – 72,5±6,3% і45,7±4,6% (р&lt;0,05)і74±6,2 % і41,0±4,1% (p&lt;0,05) відповідно. Висновки. Результати дослідження обґрунтовують необхідністьпідвищення прихильності пацієнтів і лікарів до виконання вимог здорового способу життя, зокрема, щодо здорового харчування та рекомендованого рівня фізичної активності, та підвищення обізнаності лікарів у питаннях проведення профілактичного консультування

Newtonian Collapse of Scalar Field Dark Matter

In this letter, we develop a Newtonian approach to the collapse of galaxy fluctuations of scalar field dark matter under initial conditions inferred from simple assumptions. The full relativistic system, the so called Einstein-Klein-Gordon, is reduced to the Schr\"odinger-Newton one in the weak field limit. The scaling symmetries of the SN equations are exploited to track the non-linear collapse of single scalar matter fluctuations. The results can be applied to both real and complex scalar fields.Comment: 4 pages RevTex4 file, 4 eps figure

Evolution of the Schr\"odinger--Newton system for a self--gravitating scalar field

Using numerical techniques, we study the collapse of a scalar field configuration in the Newtonian limit of the spherically symmetric Einstein--Klein--Gordon (EKG) system, which results in the so called Schr\"odinger--Newton (SN) set of equations. We present the numerical code developed to evolve the SN system and topics related, like equilibrium configurations and boundary conditions. Also, we analyze the evolution of different initial configurations and the physical quantities associated to them. In particular, we readdress the issue of the gravitational cooling mechanism for Newtonian systems and find that all systems settle down onto a 0--node equilibrium configuration.Comment: RevTex file, 19 pages, 26 eps figures. Minor changes, matches version to appear in PR

Classical and Quantum Decay of Oscillatons: Oscillating Self-Gravitating Real Scalar Field Solitons

The oscillating gravitational field of an oscillaton of finite mass M causes it to lose energy by emitting classical scalar field waves, but at a rate that is non-perturbatively tiny for small GMm, where m is the scalar field mass: d(GM)/dt ~ -3797437.776333015 e^[-39.433795197160163/(GMm)]/(GMm)^2. Oscillatons also decay by the quantum process of the annihilation of scalarons into gravitons, which is only perturbatively small in GMm, giving by itself d(GM)/dt ~ - 0.008513223934732692 G m^2 (GMm)^5. Thus the quantum decay is faster than the classical one for Gmm < 39.4338/[ln(1/Gm^2)}-7ln(GMm)+19.9160]. The time for an oscillaton to decay away completely into free scalarons and gravitons is ~ 2/(G^5 m^11) ~ 10^324 yr (1 meV/m)^11. Oscillatons of more than one real scalar field of the same mass generically asymptotically approach a static-geometry U(1) boson star configuration with GMm = GM_0 m, at the rate d(GM/c^3)/dt ~ [(C/(GMm)^4)e^{-alpha/(GMm)}+Q(m/m_{Pl})^2(GMm)^3] [(GMm)^2-(GM_0 m)^2], with GM_0 m depending on the magnitudes and relative phases of the oscillating fields, and with the same constants C, alpha, and Q given numerically above for the single-field case that is equivalent to GM_0 m = 0.Comment: 75 pages, LaTe

Supermassive black holes in scalar field galaxy halos

Ultra-light scalar fields provide an interesting alternative to WIMPS as halo dark matter. In this paper we consider the effect of embedding a supermassive black hole within such a halo, and estimate the absorption probability and the accretion rate of dark matter onto the black hole. We show that the accretion rate would be small over the lifetime of a typical halo, and hence that supermassive central black holes can coexist with scalar field halos.Comment: 5 pages RevTex4, no figures. Updated file to match published versio

Synchronised Behaviour in Three Coupled Faraday Disk Homopolar Dynamos

Hide [1] introduced a system of N self-exciting Faraday disk homopolar dynamos, symmetrically coupled through the nonlinear terms, as testbeds for analytical and numerical studies of coupled mechanical dynamos. When N = 2, the system is governed by six coupled nonlinear ordinary differential equations and thirteen dimensionless parameters [2]. Synchronised periodic and chaotic solutions axe possible, which are both linearly phase and amplitude locked [2] as well as being linearly phase locked but not amplitude locked for certain parameter combinations [3]. In this paper we extend the study to the N = 3 case (of nine coupled nonlinear ordinary differential equations and twenty two dimensionless parameters) and investigate conditions for synchronised solutions for special choices of the parameter values